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| {{Infobox_Disease | | | __NOTOC__ |
| Name = Abdominal angina |
| | {{Abdominal angina}} |
| ICD10 = K55 |
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| ICD9 = {{ICD9|557.1}} |
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| {{SI}}
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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{CMG}}; '''Associate Editor in Chief:''' {{MUT}} | | {{CMG}}; {{AE}} {{MUT}} |
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| ==Overview==
| | {{SK}} Chronic mesenteric ischemia; bowelgina; intestinal angina |
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| '''Abdominal angina''' (a.k.a. '''[[bowelgina]]''') is postprandial [[abdominal pain]] that occurs in individuals with insufficient blood flow to meet visceral demands. The term ''angina'' is used in reference to [[Angina pectoris|angina pectoris]], a similar symptom due to obstruction of the [[coronary artery]]. The American Heritage Stedman's Medical Dictionary defines abdominal angina (bowelgina) as "Intermittent [[abdominal pain]], frequently occurring at a fixed time after eating, caused by inadequacy of the mesenteric circulation. Also called intestinal angina; bowelgina." <ref>{{cite web | url = http://www.kmle.com/search.php?Search=abdominal+angina | title = ''KMLE Medical Dictionary Definition of abdominal angina'' | author = [http://www.kmle.com The American Heritage Stedman's Medical Dictionary]}}</ref>
| | ==[[Abdominal angina overview|Overview]]== |
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| == Pathophysiology == | | ==[[Abdominal angina pathophysiology|Pathophysiology]]== |
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| The pathophysiology is similar to that seen in [[angina pectoris]] and [[intermittent claudication]]. The most common cause of bowelgina is atherosclerotic vascular disease, where the occlusive process commonly involves the ostia and the proximal few centimeters of the mesenteric vessels.
| | ==[[Abdominal angina causes|Causes]]== |
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| It can be associated with:
| | ==[[Abdominal angina differential diagnosis|Differentiating Abdominal angina from other Diseases]]== |
| * [[carcinoid]]<ref name="pmid16086212">{{cite journal |author=deVries H, Wijffels RT, Willemse PH, ''et al'' |title=Abdominal angina in patients with a midgut carcinoid, a sign of severe pathology |journal=World journal of surgery |volume=29 |issue=9 |pages=1139–42 |year=2005 |pmid=16086212 |doi=10.1007/s00268-005-7825-x}}</ref>
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| * [[aortic coarctation]]<ref name="pmid14627320">{{cite journal |author=Ingu A, Morikawa M, Fuse S, Abe T |title=Acute occlusion of a simple aortic coarctation presenting as abdominal angina |journal=Pediatric cardiology |volume=24 |issue=5 |pages=488–9 |year=2003 |pmid=14627320 |doi=10.1007/s00246-002-0381-3}}</ref>
| | ==[[Abdominal angina epidemiology and demographics|Epidemiology and Demographics]]== |
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| * [[antiphospholipid syndrome]]<ref name="pmid12111088">{{cite journal |author=Choi BG, Jeon HS, Lee SO, Yoo WH, Lee ST, Ahn DS |title=Primary antiphospholipid syndrome presenting with abdominal angina and splenic infarction |journal=Rheumatol. Int. |volume=22 |issue=3 |pages=119–21 |year=2002 |pmid=12111088 |doi=10.1007/s00296-002-0196-9}}</ref>
| | ==[[Abdominal angina risk factors|Risk Factors]]== |
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| == Frequency == | | ==[[Abdominal angina natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *''Internationally'': Extremely rare. True incidence is unknown
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| *''Race'': No data available
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| *''Sex'': Females outnumber males by approximately 3 to 1
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| *''Age'': Mean age of affected individuals is slightly older than 60 years
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| ==Complete Differential Diagnosis of the causes of Abdominal angina== | | ==Diagnosis== |
| | [[Abdominal angina history and symptoms|History and Symptoms]] | [[Abdominal angina physical examination|Physical Examination]] | [[Abdominal angina laboratory findings|Laboratory Findings]] | [[Abdominal angina MRI|MRI]] | [[Abdominal angina ultrasound|Ultrasound]] | [[Abdominal angina other imaging findings|Other Imaging Findings]] | [[Abdominal angina other diagnostic studies|Other Diagnostic Studies]] |
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| *[[Atheroma]]
| | ==Treatment== |
| *[[Atherosclerosis]]
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| *[[Henoch-Schonlein purpura]]
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| *[[Ortner's syndrome]] II
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| *[[Peripheral artery occlusive disease]]
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| *[[Renovascular Disease]]
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| *[[Vasculitis]]
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| ===Complete Differential Diagnosis of the Causes of Abdominal angina=== | |
| (By organ system)
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| {|style="width:80%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |
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| [[Atheroma]],
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| [[Atherosclerosis]],
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| [[Peripheral artery occlusive disease]],
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| [[Renovascular Disease]],
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| [[Ortner's syndrome]]II,
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Chemical / poisoning'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Musculoskeletal / Ortho'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional / Metabolic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Obstetric/Gynecologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Opthalmologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Overdose / Toxicity'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Renal / Electrolyte'''
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| |bgcolor="Beige"|
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| [[Renovascular Disease]],
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Rheum / Immune / Allergy'''
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| |bgcolor="Beige"|
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| [[Henoch-Schonlein purpura]],
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| [[Vasculitis]],
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |}
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| == Clinical ==
| | [[Abdominal angina surgery|Surgery]] | [[Abdominal angina primary prevention|Primary Prevention]] | [[Abdominal angina secondary prevention|Secondary Prevention]] | [[Abdominal angina cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Abdominal angina future or investigational therapies|Future or Investigational Therapies]] |
| *''Hallmark of condition'': Disabling midepigastric or central [[abdominal pain]] within 10-15 minutes after eating.
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| *''Physical examination'': The abdomen typically is scaphoid and soft, even during an episode of [[pain]]. Patients present with stigmata of [[weight loss]] and signs of [[peripheral vascular disease]], particularly aorto-iliac occlusive disease, may be present.
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| *''Causes'': Smoking is an associated risk factor. In most series, approximately 75-80% of patients smoke.
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| ==Treatment== | | ==Case Studies== |
| Stents have been used in the treatment of abdominal angina.<ref name="pmid11292915">{{cite journal |author=Senechal Q, Massoni JM, Laurian C, Pernes JM |title=Transient relief of abdominal angina by Wallstent placement into an occluded superior mesenteric artery |journal=The Journal of cardiovascular surgery |volume=42 |issue=1 |pages=101–5 |year=2001 |pmid=11292915 |doi=}}</ref><ref name="pmid9418203">{{cite journal |author=Busquet J |title=Intravascular stenting in the superior mesenteric artery for chronic abdominal angina |journal=Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery |volume=4 |issue=4 |pages=380–4 |year=1997 |pmid=9418203 |doi=}}</ref>
| | [[Abdominal angina case study one|Case #1]] |
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| == See also == | | ==Related Chapters== |
| *[[Abdominal pain]] | | *[[Abdominal pain]] |
| *[[Ischemic colitis]] | | *[[Ischemic colitis]] |
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| ==References==
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| {{Reflist|2}}
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| {{Eponymous medical signs for digestive system and general abdominal signs}} | | {{Eponymous medical signs for digestive system and general abdominal signs}} |
| {{SIB}}
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| {{Gastroenterology}} | | {{Gastroenterology}} |
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| [[de:Angina abdominalis]]
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| [[pl:Angina abdominalis]] | | [[pl:Angina abdominalis]] |
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| [[Category:Pain]] | | [[Category:Pain]] |
| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
| [[Category:Signs and symptoms]]
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| [[Category:Overview complete]] | | [[Category:Overview complete]] |
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